CAJ | 학술논문

目的探讨应用管状胃技术与食管癌患者术后生活质量的影响.方法 2011年3-9月,按照随机对照的原则选取66例食管癌患者分为两组,管状胃组34例,术中将残胃制成宽约4 cm的管状,常规组32例,按传统手术方法切除贲门、保留全胃,对两组患者围术期并发症及术后3、6、12、24个月的生活质量(治疗相关症状、一般症状、日常生活、社会生活、情感活动、总体评价)进行比较分析.结果 66例患者均顺利完成手术,肿瘤切除率100％,无术中意外情况发生,无围术期死亡,围手术期并发症两组之间比较差异无统计学意义(P＞0.05),术后第3、6、12、24个月管状胃组生活质量总体评价指标改善比常规组明显[(78.68±2.23)分与(65.94±4.13)分,(83.79±2.40)分与(66.84±5.86)分,(86.41±1.94)分与(67.09±4.43)分,(89.02±1.71)分与(68.88±3.53)分,P均＜0.05],管状胃组术后各时间点的生活质量总体评价与同组前一个时间点比较差异均有统计学意义;在各时点上,治疗相关症状、一般症状、日常生活、情感活动在管状胃组和常规组间的比较差异均有统计学意义(P均＜0.05).术后3、6个月管状胃组和常规组在社会生活方面比较差异均无统计学意义(P均＞0.05).而常规组术后各时间点的生活质量评价与同组前一个时间点比较差异均无统计学意义(P均＞0.05).结论管状胃技术对食管癌患者术后远期生活质量的改善有益.
목적 탐토응용관상위기술여식관암환자술후생활질량적영향.방법 2011년3-9월,안조수궤대조적원칙선취66례식관암환자분위량조,관상위조34례,술중장잔위제성관약4 cm적관상,상규조32례,안전통수술방법절제분문、보류전위,대량조환자위술기병발증급술후3、6、12、24개월적생활질량(치료상관증상、일반증상、일상생활、사회생활、정감활동、총체평개)진행비교분석.결과 66례환자균순리완성수술,종류절제솔100％,무술중의외정황발생,무위술기사망,위수술기병발증량조지간비교차이무통계학의의(P＞0.05),술후제3、6、12、24개월관상위조생활질량총체평개지표개선비상규조명현[(78.68±2.23)분여(65.94±4.13)분,(83.79±2.40)분여(66.84±5.86)분,(86.41±1.94)분여(67.09±4.43)분,(89.02±1.71)분여(68.88±3.53)분,P균＜0.05],관상위조술후각시간점적생활질량총체평개여동조전일개시간점비교차이균유통계학의의;재각시점상,치료상관증상、일반증상、일상생활、정감활동재관상위조화상규조간적비교차이균유통계학의의(P균＜0.05).술후3、6개월관상위조화상규조재사회생활방면비교차이균무통계학의의(P균＞0.05).이상규조술후각시간점적생활질량평개여동조전일개시간점비교차이균무통계학의의(P균＞0.05).결론 관상위기술대식관암환자술후원기생활질량적개선유익.
Objective To evaluate the application of tubular stomach gastroesophagostomy on the life quality after esophagectomy surgery.Methods From March 2011 to September 2011,66 cases of esophageal cancer patients were divided in two groups in randomized principles.Tirty-four cases in group of tubiform gastro surgery whose the stomach was cut into tubiform stomach in width of 4 cm.And 32 cases of conventional group and whose surgery method was adopted to maintain whole stomach but cut the cardia.And then,using statistical methods,life quality after esophagectomy (treatment related symptoms,general symptoms,daily life,social life,emotional activities) and the perioperative complications were evaluated in 3,6,12,24 months in comparison and analysis.Results Sixty-six surgeries of both group patients were successfully performed,tumor resection rate was 100％,and there was no intraoperative accident also no perioperative death.There was no statistical significance of perioperative complications of 2 groups (P ＞ 0.05).Life quality of tubiform gastro group had improved apparently more than conventional group at the 3rd,6th,12th and 24th month after surgery(78.68 ±2.23 vs 65.94± 4.13,83.79 ± 2.40 vs 66.84 ± 5.86,86.41 ± 1.94 vs 67.09 ± 4.43,89.02 ± 1.71 vs 68.88 ±3.53,P＜0.05).At each time point,there were statistically significant differences between tubiform gastro group and conventional group on treatment related symptoms,general symptoms,daily life,emotion activities (P ＜0.05).At the 3rd,6th month after surgery,tubiform gastro group and the conventional group had no statistically significant difference in the aspect of social life (P＞0.05).In the conventional group,the evaluation of quality of life at each time point after surgery and before a point in time in the same group showed no statistical significance (P＞0.05).Conclusion Tubiform gastro esophagectomy has a positive influence on life quality of patients of esophageal cancer after surgery prospectively.